肝胰十二指肠器官簇移植(附一例报道)

目的探讨肝胰十二指肠联合移植术治疗1例原发性肝癌合并胰头转移的疗效。方法2004年9月,对1例原发性肝癌合并胰头转移的患者行病肝、全胰腺十二指肠、远端胃及脾脏切除后,进行肝胰十二指肠原位器官簇移植。结果移植术后胰腺功能恢复正常,未应用胰岛素维持;术后1周肝功能恢复正常。患者目前已存活5个月,肝脏和胰腺功能均正常,未发生排斥反应,未见肿瘤复发迹象,一般情况好。结论肝胰十二指肠器官簇移植为上腹部晚期恶性肿瘤患者提供了延长生命的机会,同时更为晚期肝病伴有胰腺功能不良患者的彻底治愈探索出新的手术术式。

Combined 'en bloc' liver and pancreas transplantation (one case report)

Objective To report the en bloc combined liver and pancreatic transplantation technique in the treatment of one cases of hepatoma with pancreas metastasis.Methods In September 2004, one patient with hepatoma with pancreas metastasis received en bloc combined liver and pancreatic transplantation. The allograft exocrine secretions were drained into the proximal jejunum via an end to side duodenojujunostomy (Roux-en-Y).Results The patient became immediately insulin independent postoperatively. Liver function was recovered one week after operation. Till now the grafts of liver and pancreas have been functioning well. No rejection has been observed. The recipients were currently liver disease-free and insulin-free more than 5 months.Conclusion This kind of cluster operation has been performed for non-resectable upper abdominal malignancies and also gives a more appropriate indication for combined liver and pancreas replacement in LTx candidates who coincidentally suffer from Type 1 diabetes.